Gay men’s relationship agreements in the era of pre-exposure prophylaxis: An analysis of Australian behavioural surveillance data

James MacGibbon, Timothy Broady, Kerryn Drysdale, Benjamin Bavinton , Hui Ping Evelyn Lee, Limin Mao, Garrett Prestage, Martin Holt

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Using repeated, cross-sectional behavioural surveillance data from Australia, we assessed trends in relationship agreements and casual sex among HIV-negative and untested gay and bisexual men who had regular partners during 2013–2018. We conducted three analyses: (i) trends in relationship agreements and casual sex over time; (ii) bivariate comparisons of PrEP users and non-PrEP-users to identify factors associated with PrEP use; and (iii) multivariate logistic regression to identify factors independently associated with PrEP use. The analysis of trends over time included 21,593 men, from which a sub-sample (n = 3764) was used to compare PrEP users and non-PrEP-users. We found a large increase in agreements that allowed condomless sex with casual partners, particularly by PrEP users in relationships (nearly 40% of whom had such an agreement). A further 34% of PrEP users reported having casual condomless sex without an agreement that permitted that behaviour, while 13% of non-PrEP-users also reported condomless sex with casual partners without an agreement. PrEP use was independently associated with having agreements permitting condomless sex with casual partners, recent condomless sex with casual partners, having greater numbers of male partners, recent post-exposure prophylaxis use, having an HIV-positive regular male partner, and recent condomless sex with regular male partners. Our findings show a shift away from relationship agreements in which condomless sex was only sanctioned between regular partners.
LanguageEnglish
Number of pages12
JournalAIDS and Behavior
DOIs
Publication statusE-pub ahead of print - 19 Nov 2019
Externally publishedYes

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Post-Exposure Prophylaxis
HIV
Pre-Exposure Prophylaxis
Sexual Minorities
Logistic Models

Keywords

  • HIV prevention
  • Biomedical technologies
  • Gay and bisexual men
  • Relationship agreements
  • Negotiated safety

Cite this

MacGibbon, James ; Broady, Timothy ; Drysdale, Kerryn ; Bavinton , Benjamin ; Lee, Hui Ping Evelyn ; Mao, Limin ; Prestage, Garrett ; Holt, Martin. / Gay men’s relationship agreements in the era of pre-exposure prophylaxis : An analysis of Australian behavioural surveillance data. In: AIDS and Behavior. 2019.
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abstract = "Using repeated, cross-sectional behavioural surveillance data from Australia, we assessed trends in relationship agreements and casual sex among HIV-negative and untested gay and bisexual men who had regular partners during 2013–2018. We conducted three analyses: (i) trends in relationship agreements and casual sex over time; (ii) bivariate comparisons of PrEP users and non-PrEP-users to identify factors associated with PrEP use; and (iii) multivariate logistic regression to identify factors independently associated with PrEP use. The analysis of trends over time included 21,593 men, from which a sub-sample (n = 3764) was used to compare PrEP users and non-PrEP-users. We found a large increase in agreements that allowed condomless sex with casual partners, particularly by PrEP users in relationships (nearly 40{\%} of whom had such an agreement). A further 34{\%} of PrEP users reported having casual condomless sex without an agreement that permitted that behaviour, while 13{\%} of non-PrEP-users also reported condomless sex with casual partners without an agreement. PrEP use was independently associated with having agreements permitting condomless sex with casual partners, recent condomless sex with casual partners, having greater numbers of male partners, recent post-exposure prophylaxis use, having an HIV-positive regular male partner, and recent condomless sex with regular male partners. Our findings show a shift away from relationship agreements in which condomless sex was only sanctioned between regular partners.",
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Gay men’s relationship agreements in the era of pre-exposure prophylaxis : An analysis of Australian behavioural surveillance data. / MacGibbon, James; Broady, Timothy; Drysdale, Kerryn; Bavinton , Benjamin; Lee, Hui Ping Evelyn; Mao, Limin; Prestage, Garrett; Holt, Martin.

In: AIDS and Behavior, 19.11.2019.

Research output: Contribution to journalArticleResearchpeer-review

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